Clinical Significance of Sentinel Lymph Node Detection in Patients with Invasive Cervical Cancer

The clinical significance of determining sentinel lymph nodes (SLN) in patients with invasive cervical cancer was studied. From 2013 to 2014, 30 cervical cancer patients (T1a1NxM0-T1b1NxM0) were treated at the Gynecological Oncology Department of the Cancer Research Institute. The day before surgery, four submucosal injections of 99mTc Al2O3 at a total dose of 80 MBq were made in each quadrant around the cervical tumor. Patients were submitted to preoperative lymphoscintigraphy and intraoperative SLN detection. The feasibility of preserving the reproductive potential in patients after radical abdominal trachelectomy was assessed. The 3-year, overall, disease-free and metastasis-free survival rates were analyzed. Thirty-four SLNs were detected by single-photon emission computed tomography (SPECT) and 42 SLNs were identified by intraoperative gamma probe. The sensitivity in detecting SLNs was 100% for intraoperative SLN identification and 80% for SPECT image. The reproductive potential was preserved in 86% of patients. The 3-year overall and metastases-free survival rates were 100%. Recurrence occurred in 8.6% of cases

Characterization of the Interleukin (IL)-6 Inhibitor IL-6-RFP: fused receptor domains act as high affinity cytokine-binding proteins.

Although fusion proteins of the extracellular parts of receptor subunits termed cytokine traps turned out to be promising cytokine inhibitors for anti-cytokine therapies, their mode of action has not been analyzed. We developed a fusion protein consisting of the ligand binding domains of the IL-6 receptor subunits IL-6Ralpha and gp130 that acts as a highly potent IL-6 inhibitor. Gp130 is a shared cytokine receptor also used by the IL-6-related cytokines oncostatin M and leukemia inhibitory factor. In this study, we have shown that the IL-6 receptor fusion protein (IL-6-RFP) is a specific IL-6 inhibitor that does not block oncostatin M or leukemia inhibitory factor. We characterized the complex of IL-6-RFP and fluorescently labeled IL-6 (YFPIL-6) by blue native PAGE and gel filtration. A 2-fold molar excess of IL-6-RFP over IL-6 was sufficient to entirely bind IL-6 in a complex with IL-6-RFP. As shown by treatment with urea and binding competition experiments, the complex of IL-6 and IL-6-RFP is more stable than the complex of IL-6, soluble IL-6Ralpha, and soluble gp130. By live cell imaging, we have demonstrated that YFP-IL-6 bound to the surface of cells expressing gp130-CFP is removed from the plasma membrane upon the addition of IL-6-RFP. The apparent molecular mass of the IL-6.IL-6-RFP complex determined by blue native PAGE and gel filtration suggests that IL-6 is trapped in a structure analogous to the native hexameric IL-6 receptor complex. Thus, fusion of the ligand binding domains of heteromeric receptors leads to highly specific cytokine inhibitors with superior activity compared with the separate soluble receptors